Comparative Pharmacology
Head-to-head clinical analysis: COTRIM versus TRIMETHOPRIM SULFATE AND POLYMYXIN B SULFATE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: COTRIM versus TRIMETHOPRIM SULFATE AND POLYMYXIN B SULFATE.
COTRIM vs TRIMETHOPRIM SULFATE AND POLYMYXIN B SULFATE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
COTRIM is a combination of trimethoprim and sulfamethoxazole; sulfamethoxazole inhibits dihydropteroate synthase, and trimethoprim inhibits dihydrofolate reductase, sequentially blocking bacterial folate synthesis.
Trimethoprim inhibits bacterial dihydrofolate reductase, blocking tetrahydrofolate synthesis and thereby inhibiting thymidine synthesis. Polymyxin B disrupts bacterial cell membrane integrity by binding to lipopolysaccharides in Gram-negative bacteria.
1 double-strength tablet (160 mg trimethoprim + 800 mg sulfamethoxazole) orally every 12 hours for 5-14 days; 15-20 mg/kg/day (based on trimethoprim) IV divided every 6-8 hours for severe infections.
One drop in each affected eye every 2 to 4 hours for 7 to 10 days.
None Documented
None Documented
Sulfamethoxazole: 9-11 hours (normal renal function); trimethoprim: 8-10 hours. Extended in renal impairment (SMX up to 30h, TMP up to 24h).
Trimethoprim: 8-10 hours (normal renal function); Polymyxin B: 6 hours (prolonged in renal impairment).
Renal: 50-70% unchanged sulfamethoxazole, 15-30% N4-acetylated metabolite; trimethoprim: 50-60% unchanged, 10-20% metabolites. Biliary/fecal: minimal.
Trimethoprim: renal (80-90% unchanged, 10-20% metabolites); Polymyxin B: renal (60% unchanged, 40% nonrenal).
Category C
Category D/X
Antibiotic
Antibiotic